Free Civil Summons - Michigan

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SUMMONS IN A CIVIL ACTION

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1. UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF MICHIGAN

DOCKET NO.

v.

TO:

YOU ARE HEREBY SUMMONED and required to file with the Clerk of this Court and serve upon:
PLAINTIFF'S ATTORNEY

an answer to the complaint which is herewith served upon you, within days after service of this summons upon you, exclusive of the day of service. If you fail to do so, judgment by default will be taken against you for the relief demanded in the complaint.
TRACEY CORDES, CLERK BY: (Deputy Clerk) (SEAL) DA TE D:

9 399 Fed eral Building
110 Michigan St., N.W . Grand Rapids, MI 49503

9

229 Fed eral Building 202 W . W ashington St. Marquette, MI 49855

9

B-35 Fed eral Building 410 W. M ichigan Ave. Kalamazoo, MI 49007

9

113 Fed eral Building 315 W. Allegan Lansing, MI 48933

2. RETURN OF SERVICE Service of the Summon s and Compla int was made by me.*** DA TE : Name o f Serve r (print): Title:
CHECK ONE BOX BELOW TO INDICATE APPROPRIATE METHOD OF SERVICE

9 9 9 9

Served person ally upo n the defendant. Place where served:

Left copies thereof at the defendant's dwelling house or usual place of abode with a person of suitable age and discretion then residing therein. Name o f perso n with whom the summon s and com plaint were left:

Returned unexe cuted :

Othe r (specify):

3. STATEM ENT OF SERVICE FEES
TRAVEL SERVICES TOTAL

$

$ DECLARA TION OF SERVER

$

I declare under penalty of perjury under the laws of the United States of America that the foregoing information contained in the Return of Service and S tateme nt of Service F ees is true and correct. Executed on Date Signature of Server

Address of Server
*** See Rule 4 of the Federal Rules of Civil Procedure re who may serve a summons
4/2005